Arterial Hypertension Symptoms Research Articles

Альдостеронсинтаза, поліморфізм її гена CYP11B2 при артеріальній гіпертензії і асоційованих з нею кардіоваскулярних захворюваннях (огляд літератури)

В огляді надані дані зарубіжної та вітчизняної літератури щодо патогенетичної ролі альдостерону, рівнів альдостеронсинтази і поліморфізмів гена даного ферменту у хворих на різні форми артеріальної гіпертензії, при асоційованих з нею захворюваннях серця і судин, фібриляції передсердь, метаболічному синдромі, патології нирок, головного мозку. Розглядаються функції альдостерону, рівнів альдостеронсинтази і поліморфізмів гена даного ферменту в серцево-судинному ремоделюванні, можливості застосування даних маркерів для диференційно-діагностичних цілей, перспективи терапевтичного використання інгібіторів альдостеронсинтази серед різних категорій хворих з ознаками артеріальної гіпертензії.

Symptoms, impacts, and suitability of the Pulmonary Arterial Hypertension-Symptoms and Impact (PAH-SYMPACT\u2122) questionnaire in patients with sarcoidosis-associated pulmonary hypertension (SAPH): a qualitative interview study

BackgroundSarcoidosis-associated pulmonary hypertension (SAPH) is a prevalent and serious complication of sarcoidosis. No SAPH-specific self-report instruments for assessing SAPH symptoms and their impact on patients are available to date. This study sought to determine whether the Pulmonary Arterial Hypertension-Symptoms and Impact (PAH-SYMPACT™) questionnaire is suitable for use in patients with SAPH.MethodsPatients diagnosed with SAPH participated in qualitative one-on-one telephone interviews to better understand SAPH symptoms and their impacts on patients’ lives and to determine the appropriateness of the PAH-SYMPACT™ for use in patients with SAPH. The interviews comprised concept elicitation, completion of the PAH-SYMPACT™, and cognitive debriefing. Interview transcripts were analyzed by content analysis.ResultsEleven patients with SAPH were interviewed between August 2019 and June 2020. In the concept elicitation, all 11 participants endorsed shortness of breath and nine participants (82%) rated it as their “most bothersome or severe” symptom. Impacts endorsed by all 11 participants were difficulty walking uphill or up stairs and difficulty in performing daily activities. Cognitive debriefing indicated that the PAH-SYMPACT™ items were relevant and understandable to most participants and reflected their experiences of SAPH. Participants indicated that no key symptoms or impacts of SAPH were missing. They also reported that the PAH-SYMPACT™ instructions and response options were clear, and that it would be feasible to complete the 11 symptom items and one oxygen use item as part of their daily schedule.ConclusionsThis study suggests the PAH-SYMPACT™ is suitable for assessing symptoms and their impact in patients with SAPH. However, larger longitudinal studies are needed to confirm that it is fit for use in this patient population and that it can be used to reliably detect temporal changes in patients’ symptom status.Trial registration Not applicable.

The efficacy of diuretics in complex treatment of patients with hypertension according to the Gly460Trp polymorphism of the α-adducin gene

The aim of the study was to investigate the effect of thiazide diuretics on blood pressure (BP) depending on Gly460Trp ADD1 gene polymorphism in arterial hypertension (AH) patients of the Ukrainian population in order to predict their individual treatment efficacy. Material and methods. The study included 232 persons: 120 patients with verified stage II AH and 112 healthy individuals. Restriction fragment length polymerase chain reaction (PCR-RFLP) was used to detect genotype (the Gly460Trp-polymorphic locus of the ADD1 gene). The patients received standard therapy, which included ACE inhibitor – ramipril 5 mg, calcium channel antagonist – amlodipine 5 mg, statin – atorvastatin 20 mg, acetylsalicylic acid 75 mg. The patients were randomized into two groups: group I (60 persons) additionally taking treatment with 1.5 mg of indapamide retard and group II (60 persons) – with 25 mg of hydrochlorothiazide. The dynamic reduction of blood pressure has been assessed every 4 weeks for 2 months. Results. Among 120 patients with AH, 91 persons (75.8 %) were homozygous for the G allele (GG), 26 persons (21.7 %) – heterozygous (GT) and 3 persons (2.5 %) – homozygous for the T allele (TT), while the G allele frequency in patients with hypertension was 0.87, and the T allele – 0.13. 98 healthy individuals (87.5 %) were homozygous for the G allele, 13 individuals (11.6 %) were heterozygous, and 1 person (0.9 %) was homozygous for the T allele. The carrier frequency of the G and T alleles was 0.93 and 0.07, respectively. Allelic distribution indicated the predominance of the G allele carriers by Gly460Trp polymorphism of the ADD1 gene among the Ukrainian population, regardless of whether AH symptoms were present. It is noteworthy that the number of the T allele carriers was 2 times large among symptomatic patients than that among healthy individuals. In patients with the T allele, the hypotensive efficacy of indapamide was almost 3 times higher than that in patients with the G allele. The antihypertensive effect of hydrochlorothiazide in patients with the GT and TT genotypes was 2 times greater than that in the GG genotype carriers depending on the presence of the T allele G460T polymorphism of ADD1 gene in the genotype. Conclusions. Allelic distribution indicates the predominance of the G allele carriers by Gly460Trp ADD1 gene polymorphism among the Ukrainian population, regardless of whether AH symptoms are present. Among patients with AH, the accumulation of the T allele G460T polymorphic marker of the α-adducin gene is 2 times more than that in healthy individuals. Patients carrying the T allele demonstrate 2 times higher hypotensive efficacy of indapamide compared with hydrochlorothiazide.

Anxiety and depression symptoms in arterial hypertension: the influence of antihypertensive treatment. The HUNT study, Norway

Antihypertensive drugs have been suggested to modulate symptoms of depression and anxiety. It is disputed whether this is due to the hypertension per se, its treatment, or both. The aim of this study was to investigate these associations in a large population sample. 55,472 participants in the Nord-Trøndelag Health Study (HUNT 2, 1995-1997), Norway, who completed the Hospital Anxiety and Depression rating Scale, were divided into 3 groups according to their diastolic blood pressure and antihypertensive treatment status. A cut-off of≥90mmHg diastolic blood pressure was used to identify hypertensive status. Differences in anxiety and depression symptom levels in untreated and treated hypertensives (all treatments) versus the normotensive reference group were explained by differences in age and gender distribution in the three groups in this study. However, the receipt of two or more antihypertensive drugs was associated with depressive symptoms alone (OR=1.40, 95% CI=1.03-1.90), but not with symptoms of anxiety (OR=1.14, 95% CI=0.83-1.57) or mixed anxiety and depression (OR=1.19, 95% CI=0.82-1.72) in the fully adjusted model, compared to untreated hypertension. Antihypertensive monotherapy (all agents) nor any single antihypertensive drug class were associated with symptoms of depression, anxiety, or mixed anxiety and depression. There may be a positive association between multi antihypertensive drug use and symptoms of depression, whereas this was not found in persons with symptoms of anxiety or mixed anxiety and depression. This might reflect poor antihypertensive treatment adherence leading to polypharmacy, or other unfavorable health behaviors in people with symptoms of pure depression.

On Ocular Symptoms in Arterial Hypertension

On Ocular Symptoms in Arterial Hypertension